Hospitals and Zebras and Robots...oh my!

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Wednesday...Bedtime...Blog. It is very strange to get ready for bed and then notice it is afternoon back home. We both adjusted really well to the time difference. Thank you crazy residency lifestyle and On-Call lack of sleep schedules. Being awake for 30 hours straight several times a week really has its benefits. Especially if you need to adjust to jet lag and work the next day. Seriously though, I do think our schedules and changing rotations every month really made adjusting to a new time-zone, a new home, and new work environment much easier. We both had another busy but great day at KSH (Katature State Hospital). If you missed our blog from yesterday, go back and read it, its good :-) Our morning started our with a busy rounds on my ward, and a not so busy rounds on Raissa's ward...currently her patients are more like at a playground than a hospital, with most still waiting for bus rides. Today we brought some toys and the kids LOVED it! (thank you Lauren and Katie for the idea of Oriental Trading Company...we got a ton of little fun things for not much). We gave a few things out, like small inflatable beach balls (they were playing with old shrinking balloons as balls), sticky hand things that you play with (parents probably remember kids throwing them against the walls and they stick), and some silly band bracelets. They had so much fun. The sisters (nurses) also were excited for the kids, which was great to see. one really wanted pictures so you can see those! The kids are so adorable. My ward has much sicker children. they are all less than 2, most are young infants. Some have been in for a while, like the baby I posted a picture of yesterday. Who we finally diagnosed today! Thank You Smith's (a Peds book for genetic disorders). It is not common and I have never even heard of it but the diagnosis fits. Anyway, after rounds we had a few more blood draws and IV line placements. They call it a drip here, which is common, but if a child needs and IV they say they need a drip placed. It makes sense, but I didn't know they meant and IV placed at first. One baby I was not successful, it took the medical officers and I several attempts each before we got one. She was a tiny (5kg) almost 3 year old little girl with RVD, TB, and new pertussis which she got while in hospital. She is so sick, and so small. I just wanted to hold her all day. But her momma is so loving and caring, most of them are and stay on the floors in the wards to care for the babies. It would be harder to see if the mother's were not there. It is so common for illnesses to be passed around the wards. There are a few "isolation" rooms, but they are not isolation like the states. So the TB patients are in with the RVD patients and the bronchiolitis babies and the septic neonates. And we have had quite a few cases of chicken pox. The two I saw in the wards yesterday, one came in with secondary pneumonia and the 1 month old caught chicken pox from this patient while he was in for something else.
We sat during lunch and talked for an hour with one of the interns who is new to peds, but done with her 2 years of internship after this rotation. She is in the prem unit (like NICU) right now, so we haven't seen her before. She is from Zimbabwe and very nice. It was interesting to see her perspective on things, and then of course we just talked about normal things like shopping and TV :-) Outpatient clinic at POPD was busy until 330pm and then empty. we were so confused, but one of the sisters told us we were waiting for a busload from the south. (the ministry of health buses people in from all over the country of Namibia to come to Katatura, and each place has set days/times they come). The problem was the bus didn't come until late, around 430. So we saw as many patients as we could, but everyone locks up the POPD at 5pm, no matter what. We are not allowed to stay to see more patients. So, the rest had to go to Casualty (the ER) to be seen. And there were so many. I felt bad. Raissa had another 430pm admission (to my ward of course)...a 1 month old with high fever and no other source. So, full septic work up and Amp and Gent (no Claforan here, they will do only Amp/Gent combo). So hopefully she is better in the a.m. and we find a source. We cooked with Pam tonight, and made one of my personal favorites...breakfast for dinner. We ate outside and were joined by a Gecko on the patio. Apparently they had not seen one the whole time they have been here! He didn't eat much. Now writing this and time for bed. We get to sleep in a little tomorrow since Dr. Brown is giving a lecture at 930 and we don't arrive before then. Hopefully more interesting stories to tell tomorrow.
Did I mention the trip to the grocery? It was an adventure. And you can buy Zebra. Here is a picture to prove it. Oh, and I forgot about the robots in the title. Robot is Afrikaans for traffic light. Interesting.
Good night all.

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Photos

Katatura State Hospital
on the right side of the picture. Pediatrics is top floor, #8.